Colon surgery for cancer in the very elderly. Cost and 3-year survival.

Is colon cancer surgery justified in the very elderly from the standpoint of cost and 3-year survival rates? Two hundred eighty patients undergoing major surgery for colon cancer during 1981-1983 were divided into a group of 61 with ages greater than or equal to 80 (GE80) and 219 less than 80 (LT80). Although those GE80 had higher median lengths of stays (18 vs. 15 days, p = 0.013) and hospital charges ($7845 vs. $6414, p = 0.002) than those LT80, there was no difference 3-year survival curves (Mantel-Cox p = 0.7155). Proportional Hazards Linear Model (multivariate) analysis showed that the risk of mortality could be predicted by disease stage (p less than or equal to 0.0001) or type of operation required (p less than or equal to 0.0001) but not by age group (p = 0.4552). It is concluded that surgery for colon cancer in the very elderly is justifiable and should not be restricted on the basis of age alone.